ASSESSMENT AND MANAGEMENT OF PAIN IN THE ADULT PATIENT WITH ADVANCED CANCER.The diagnosis of advanced cancer often causes feelings of despondency, futility and fear in cancer patients and their loved ones.
Introduction
In the UK, approximately 350,000 individuals develop cancer each year.
Around 160,000 of those diagnosed will die of the disease.
The diagnosis of advanced cancer often causes feelings of despondency, futility and fear in cancer patients and their loved ones.
Advanced stage cancer may be diagnosed at the onset of the disease, may arise because of ongoing disease progression, or may develop following a recurrence after a period of remission.
In patients with advanced cancer, pain is frequently the most common, and most feared symptom.
Pain due to advanced cancer is the most under-treated symptom related to the end-of-life; it is thought that pain is under-treated in approximately 50% of cancer patients, despite clear local, national, and international guidelines related to its management.
Comprehensive holistic assessment is essential for the effective management of cancer pain in the adult patient.
Cancer pain – what causes it, and how does it affect patients?
Pain due to advanced cancer is complex – it can be both acute and chronic
Cancer pain can be a direct consequence of the primary pathology – e.g. distant metastases or nerve compression.
It can also be caused by cancer treatment – e.g. surgery, chemotherapy, radiotherapy.
Cancer pain commonly exists as a combination of various mechanisms:
Somatic – a nociceptive pain arising from skin, tissue, or muscle
Visceral – a nociceptive pain arising from internal organs
Nociceptive – chronic pain caused by damage to tissues
Neuropathic – pain from damage or disease affecting the somatosensory nervous system.
Uncontrolled pain affects an individual’s response to illness, limits their self-caring ability, and reduces their overall quality of life.
